Asthma is the most common chronic illness of childhood, with increasing prevalence & morbidity during recent years. Studies of pediatric asthma from the 1980's reported an increase of 29% in prevalence and 43% in hospitalization rate. Concern about the morbidity of asthma has led to guidelines for increased use of standard therapies & trials of new medications. (IB) is a synthetic derivative of atropine which relieves bronchospasm by blocking pulmonary cholinergic receptors. The structure of IB contains a quaternary amine group that decreases systemic absorption. This modification prevents the systemic cardiac, ocular, and genito-urinary side effects that are observed with atropine. Over the past twenty years, IB has been used extensively in Europe & Canada for asthma & related illnesses. After FDA approval, studies in the US have demonstrated it to be an effective treatment for adults with asthma & chronic obstructive pulmonary disease.